Famous faces wearing braces

The UK press has an insatiable appetite for healthcare stories, especially when there is a celebrity angle. This can be a challenge for orthodontists who find themselves treating a patient who is in the public eye. For while celebrity patients deserve the same level of confidentiality as everyone else, it can be harder to protect their privacy.

The growing popularity of orthodontic treatment for adults has been led by the development of new, more discrete treatment options with those in the public eye seeking treatment for crooked or protruding teeth.

There are famous faces wearing braces all over the internet and some are prepared to publicly credit their orthodontist for their new smile. But although a few celebrities might choose to make their dental work public, most rightly expect the same level of privacy as any other patient. Unfortunately, given the lengths some journalists will go to get a story, extra vigilance may be required to avoid breaching confidentiality. The following advice should help you meet your ethical obligations:

Give yourself time

If a journalist calls the practice, don’t feel pressured into speaking to them immediately. Ask for their details – name, publication and phone number – so you can contact them in your own time. Unfortunately, journalists are unlikely to go away if you just ignore them, so it’s advisable get advice from your dental defence organisation before calling them back.

Explain your ethical duty

In most cases, the most appropriate response if you are asked by a journalist about any patient will be to state that you cannot comment because of your duty of confidentiality. Bear in mind that it’s possible to inadvertently breach your legal and ethical obligations by confirming that someone is a patient.

Even if you believe that the patient has put information into the public domain, this doesn’t mean that you are free to comment or confirm the details without their expressed consent. Remember that you are always ‘on the record’.

Be careful what you say, as any comments you make could find their way into a story, even if you believe you are having an ‘off the record’ conversation. The best rule of thumb is to accept that the journalists will record or take down everything you say and can use it in their story. While you might not be quoted directly, the source of the information may still be obvious to the patient.

It is therefore much better to say as little as possible. Journalists usually know that dental professionals have a duty of confidentiality and will not pester you if you stand firmly by the line that you cannot comment for this reason.

Consult the patient if practicable

In some cases, it might be possible to contact the celebrity patient and explain that you have been approached by the media. You should reassure them that your duty of confidentiality means you will not comment about their treatment without their consent. However, in the circumstances, the patient may appreciate a warning and may take the opportunity to agree a short statement. If so, it is advisable to make a note of the discussion and the precise wording of any statement.

Put confidentiality safeguards in place

It makes sense to have practice policies and procedures in place to prevent any inadvertent confidentiality breaches. These include ensuring computerised dental records are protected from unauthorised access.

All staff at the practice should already be aware of their duty to uphold patient confidentiality and have been trained to do so. However, you may want to remind them in case they are tempted to tell close friends or family about a celebrity patient. Nor should social media be used to discuss individual patients, however secure the user’s privacy settings.

Seek permission for any publicity

Celebrity endorsement can be a powerful promotional tool so depending on the outcome you might want to ask the patient if they would be willing to provide a testimonial. However, in seeking their written consent, you should explain the purpose, what sort of audiences the material will be shown to and make it clear that they can withdraw their permission at any time. You must not put them under any pressure to agree.

The DDU’s guidance on ensuring the confidentiality of patients in the public eye can be summarised as:
• If the media ask about a patient under your care, explain that you cannot comment because of your duty of confidentiality.
• Ask patients who they would be happy for you to share information with.
• Take steps to prevent unauthorised access to dental records, for example by logging out of computers when not in use.
• Beware of discussing patients where you can be overheard, such as in the reception area.
• Be wary of commenting on cases via social media. Bear in mind that even seemingly superficial details could be identifiable.